July 31, 2004

Negative Interactions in Marriage Can Lead to More Health Problems in Older Couples

Even outweighs any positive behavior effects

HONOLULU - Having good communication, a reliable partner and understanding in a marriage can boost a person's health, say experts. But having more negative than positive exchanges can diminish these benefits in the relationship and actually hurt one's health, especially for those who have been married for a long time, says a new study that examines the role of marital quality in the physical health of mature adults - over age 50. Findings of the study will be presented at the 112th Annual Convention of the American Psychological Association (APA) in Honolulu.

Certain behaviors by one partner in long-term marriages appear to contribute to a spouse's likelihood of experiencing chronic health problems, more disability and poorer perceived health, according to a study that looks at 729 adults who were at least 50 years of age and currently married and in their first marriage. Researcher Jamila Bookwala, Ph.D., of Lafayette College used data from the National Survey of Midlife Development in the United States (MIDUS) on five dimensions of marital quality (disagreement, positive and negative spousal behaviors, overall quality of relationship and marital communication) and on four indicators of physical health (physical symptoms, chronic health problems, physical disability and perceived health). This is one of the first studies to use a large probability-based sample of middle-aged and older individuals.

In this study, said Bookwala, the marital quality of the relationship does contribute significantly to the physical health of adults aged 50 and older. In particular, the occurrence of negative spousal behaviors, such as the spouse making excessive demands, being too critical or argumentative, being unreliable or continually agitating one's partner was associated with poorer physical health for the respondent. And, said Bookwala, these negative behaviors outweighed any positive spousal behaviors in influencing physical health.

Bookwala controlled for sociodemographic variables (socioeconomic status, education, family background) and symptoms of depression to rule out these factors as influencing the respondents' health problems.

"From these results," said Bookwala, "it is likely that the occurrence of negative behaviors from one's spouse outweighs the role of positive behaviors in physical health. It could be that the chronicity of negative spousal behaviors may have a cumulative and long-term effect on health outcomes similar to those associated with other chronic psychological stressors such as being a caregiver."

Negative behaviors between spouses may be changeable through the appropriate interventions, said Bookwala. Marital therapy is designed to reduce or eliminate the exchange of criticism and excessive demands, which may prevent the negative emotions between spouses from escalating. If the marital therapy lowered the marital distress, then it may be possible to protect couples from health problems that arise from the negative behaviors occurring in the marriage, added Bookwala.

Presentation: "Marital Quality and Physical Health in Mature Adults," Jamila Bookwala, Ph.D., Lafayette College; Session 4072, 9:00 - 9:50 AM, Saturday, July 31, Hawaii Convention Center, Level 1 - Exhibit Hall, Kamehameha Exhibit Hall.

Full text of this article is available from the APA Public Affairs Office.

Reporters: Jamila Bookwala, PhD, can be reached before and after the convention at (610) 330-5285 or by Email

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.